血清CA125、CA19-9、CA724、SCCAg联合检测在子宫内膜癌中的诊断价值

Diagnostic value of combined detection of serum CA125, CA19-9, CA724 and SCCAg in endometrial cancer

目的探讨糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、糖类抗原724(CA724)与鳞状细胞癌抗原(SCCAg)联合检测在子宫内膜癌中的诊断价值。方法采用电化学发光免疫分析法检测277例子宫内膜癌患者(子宫内膜癌组)、95例子宫良性疾病患者(子宫良性疾病组)和60例健康体检者(健康对照组)的血清CA125、CA19-9、CA724和SCCAg水平,分析3组受试者血清肿瘤标志物水平的相关性,评价各指标单项及联合检测在子宫内膜癌中的诊断价值。结果子宫内膜癌组患者的血清CA125、CA19-9、CA724和SCCAg水平均高于子宫良性疾病组和健康对照组,且子宫内膜癌组患者的血清CA125、CA19-9和SCCAg水平互呈正相关(P﹤0.05)。子宫良性疾病组患者的血清CA125、CA19-9和SCCAg水平均高于健康对照组(P﹤0.05)。子宫内膜癌组患者的血清CA125、CA19-9、CA724和SCCAg的阳性检出率均高于子宫良性疾病组和健康对照组(P﹤0.05)。ROC曲线结果显示,在子宫内膜癌组和健康对照组中,4项肿瘤标志物联合检测的曲线下面积(AUC)、灵敏度和准确度均高于单项指标检测结果(P﹤0.01);在子宫内膜癌组和子宫良性疾病组中,4项肿瘤标志物联合检测或CA125、CA19-9和SCCAg3项指标联合检测时的AUC、灵敏度、准确度均高于单项指标检测结果(P﹤0.05),但4项肿瘤标志物联合检测与3项指标联合检测诊断子宫内膜癌的AUC、灵敏度、特异度、准确度比较,差异均无统计学意义(P﹥0.05)。结论CA125、CA19-9和SCCAg联合检测可为鉴别良恶性子宫内膜疾病提供重要的参考,再联合CA724检测的意义不大。

Objective To investigate the diagnostic value of carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 724(CA724)and squamous cell carcinoma antigen(SCCAg)in endometrial cancer.Method The levels of serum CA125,CA19-9,CA724 and SCCAg in 277 patients with endometrial cancer(endometrial cancer group),95 patients with benign uterine disease(benign uterine disease group)and 60 healthy persons(healthy control group)were detected by electrochemiluminescence immunoassay.The correlation of serum tumor markers in the three groups of subjects,and the diagnostic value of single and combined detection of each indicator in endometrial cancer were analyzed.Result The levels of four serum tumor markers in the endometrial cancer group were higher than those in the benign uterine disease group and the healthy control group(P<0.05).The levels of serum CA125,CA19-9 and SCCAg in the endometrial cancer group were positively correlated with each other(P<0.05).The levels of serum CA125,CA19-9 and SCCAg in the benign uterine disease group were higher than those in the healthy control group(P<0.05).The positive rates of serum CA125,CA19-9,CA724 and SCCAg in endometrial cancer group were higher than those in benign uterine disease group and healthy control group(P<0.05).ROC curve results showed that in the endometrial cancer group and the healthy control group,the area under the curve,sensitivity and accuracy of the four tumor markers combined detection were higher than the single index detection(P<0.01).In the endometrial cancer group and the uterine benign disease group,the combined detection of three or four serum tumor markers showed higher area under the curve,sensitivity and accuracy than single index detection(P<0.01),but four serum tumor markers combined detection with three serum tumor markers in the diagnosis of endometrial cancer area under the curve,sensitivity and accuracy comparison,there were no statistically significant difference(P>0.05).Conclusion The combined detection of CA125,CA19-9 and SCCAg can provide an important reference for the identification of benign and malignant endometrial diseases.The value of combining with CA724 is not high.